| The diagnostic and prognostic utility of positron emission tomography/computed tomography-based follow-up after radiotherapy for head and neck cancer. | |
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MedLine Citation:
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PMID: 19544537 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The detection of subclinical head and neck cancer recurrence or a second primary tumor may improve survival. In the current study, the authors investigated the clinical value of a follow-up program incorporating serial (18)F-fluorodeoxyglucose-positron emission tomography integrated with computed tomography (PET/CT) in the detection of recurrent disease in patients with head and neck cancer. METHODS: A total of 240 PET/CT scans were reviewed in 80 patients with head and neck cancer who were treated with radiotherapy (RT) from July, 2005 through August, 2007. All patients were followed with clinical examination, PET/CT, and correlative imaging for a minimum of 11 months (median follow-up, 21 months). RESULTS: The sensitivity, specificity, and positive and negative predictive values of PET/CT-based follow-up for detecting locoregional recurrence were 92%, 82%, 42%, and 98%, respectively. Corresponding values for distant metastases or second primary tumors were 93%, 96%, 81%, and 98%, respectively. Eight patients (10%) developed disease recurrences or second primary tumors that were amenable to salvage surgery with negative surgical margins. The 2-year progression-free survival and 2-year overall survival rates were significantly different between patients who had a negative and those with a positive PET/CT result within 6 months of the completion of RT (93% vs 30% [P<.001] and 100% vs 32% [P<.001], respectively). CONCLUSIONS: Although post-therapy follow-up using PET/CT is reportedly associated with a high false-positive rate in the irradiated head and neck, PET/CT appears to be a highly sensitive technique for the detection of recurrent disease. Furthermore, negative PET/CT results within 6 months of the completion of RT offer significant prognostic value. |
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Authors:
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Johnny Kao; Ha Linh Vu; Eric M Genden; Bharat Mocherla; Eunice E Park; Stuart Packer; Peter M Som; Lale Kostakoglu |
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Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Cancer Volume: 115 ISSN: 0008-543X ISO Abbreviation: Cancer Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-09-23 Completed Date: 2009-11-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0374236 Medline TA: Cancer Country: United States |
Other Details:
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Languages: eng Pagination: 4586-94 Citation Subset: AIM; IM |
Copyright Information:
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2009 American Cancer Society. |
Affiliation:
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Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York, USA. johnny.kao@mountsinai.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Carcinoma, Squamous Cell / radiography*, radionuclide imaging*, radiotherapy Female Fluorodeoxyglucose F18 / diagnostic use Follow-Up Studies Head and Neck Neoplasms / radiography*, radionuclide imaging*, radiotherapy Humans Male Middle Aged Neoplasm Metastasis / radionuclide imaging Neoplasm Recurrence, Local / radionuclide imaging Neoplasms, Second Primary / radionuclide imaging Positron-Emission Tomography* Prognosis Sensitivity and Specificity Tomography, X-Ray Computed* |
| Chemical | |
Reg. No./Substance:
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63503-12-8/Fluorodeoxyglucose F18 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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